Hospital systems at odds over 'poaching' physicians

Sunday

Jun 17, 2012 at 12:01 AMJun 17, 2012 at 10:10 AM

Competition between nonprofit hospital systems for cardiologists and other specialty physicians is inflating health-care costs and isn't always in the community's best interest, OhioHealth CEO David Blom said last week.

Ben Sutherly, The Columbus Dispatch

Competition between nonprofit hospital systems for cardiologists and other specialty physicians is inflating health-care costs and isn’t always in the community’s best interest, OhioHealth CEO David Blom said last week.

Doctors have long migrated between health systems, and that movement needs to be respected, Blom said. But he told The Dispatch that the pressure to fill beds at hospitals is high now, and hospital systems need to be mindful of the community’s interests when developing their business plans.

“In many communities around the country, the issue of physician poaching has been going on for years,” Blom said. “The result is an escalation of health-care costs that the business community ultimately pays,” often with little benefit for patients and those who pay the bills.

And, he added, “the patients get stuck in the middle.”

OhioHealth is especially sensitive to the issue, having lost 21 cardiologists over the past six years, according to an official there.

Most recently, eight independent cardiologists, who make up Heart Specialists of Ohio, went to work for Ohio State University’s Wexner Medical Center. They had been affiliated with OhioHealth’s Riverside Methodist Hospital; seven of them had contracts to operate OhioHealth’s cardiology practice in Springfield.

OhioHealth sued the cardiologists for violating non-compete clauses in their contracts to operate OhioHealth’s cardiology practice in Springfield.

The lawsuit also said the doctors had shared confidential information about OhioHealth’s practice with Ohio State.As part of a settlement last week, the cardiologists agreed to pay OhioHealth $125,000. OhioHealth officials acknowledged that amount won’t cover their legal bills, but they said the sum is “formal recognition that we were unfairly forced to protect our rights.”& amp; lt; /p>

An Ohio State official disputed the degree to which the university poaches doctors.

“Taking from local hospitals certainly is not our strategy,” said Dr. Charles Lockwood, dean of Ohio State’s College of Medicine.

He said Ohio State is more likely to seek out that talent at other academic research institutions around the nation.

In addition, Lockwood said, health systems legally can’t formally agree not to compete for talent because that could create an antitrust liability.

“Our goal is to be the best university we can be, and that means recruiting the best talent from wherever we can find it,” Lockwood said. “In general, competition is good.”

Physician turnover was 6.5 percent in 2011, up slightly from 6.1 percent in 2010, according to a physician survey by St. Louis-based health-care search firm Cejka Search. According to that survey, one physician group estimated that turnover can cost up to $1?million when recruitment and startup costs and lost revenue are considered.

But pay inflation is also a consideration.

“We have chosen not to match expensive offers because it does increase the costs,” OhioHealth’s Blom said.And with health care approaching 18 percent of the nation’s gross domestic product, “I believe in the future, costs are going to matter,” he said.

In 2006, OhioHealth’s Riverside lost a group of five cardiologists to Ohio State. And in 2009, Clinical Cardiovascular Specialists, a group of six cardiologists, left Riverside for Mount Carmel Health System’s St.?Ann’s Hospital.

The movement hasn’t been entirely in one direction. An Ohio State neurologist, for example, moved to OhioHealth in 2009. But an OhioHealth spokesman said large groups of physicians haven’t left other local hospital systems to become OhioHealth employees.

Dr. Richard “Rick” Streck, chief medical officer of Mount Carmel, said it doesn’t have a formal policy on physician recruitment. But, he added, “we have not actively approached specialists that are employed by other regional health systems unless (the physicians) have approached us.”

But Mount Carmel is creating a physician governance model for its employed-physician groups. The hospital system said it hopes that doctors will find the approach attractive, Streck said. “We want the physicians to feel they’re in control of the clinical care of patients.”

Court documents show OhioHealth officials believed that Ohio State medical-center leaders misled them about the university’s recruitment of the cardiologists. OhioHealth also feared how the public would view Riverside’s cardiology program in the wake of the latest physician defections to Ohio State. The documents also showed widespread belief among OhioHealth officials that Ohio State is luring doctors with generous compensation packages.

OhioHealth employs 44 cardiologists, and Blom said its cardiology program remains the region’s largest and most-comprehensive. Its market share of cardiology is about 45 percent, according to an OhioHealth spokesman.

“Yes, over the past five to seven years, a number of cardiologists left our organization,” Blom said. “At the time, we had more than anyone else in town, and others needed to fill their beds, so they came after our physicians.“... Today, we feel great about the fact that we feel we kept the best doctors, and we also have brought in new talent.”

While tensions have run high at OhioHealth over the departure of Heart Specialists of Ohio, Dr. Barry George, one of the eight cardiologists who were sued, called last week’s settlement “a victory for patients.”

George said he spearheaded employment talks with Ohio State.

“We were looking for a way to continue to survive as a business and continue to best care for patients,” he said.